Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017

Benno Kohlmaier; Nina A. Schweintzger; Manfred G. Sagmeister; Vendula Švendová; Daniela S. Kohlfürst; Astrid Sonnleitner; Manuel Leitner; Andrea Berghold; Erich Schmiedberger; Franz Fazekas; Alexander Pichler; Jana Rejc-Marko; Daniel Růžek; Lucie Dufková; Darina Čejková; Petr Husa; Martina Pýchová; Lenka Krbková; Václav Chmelík; Věra Štruncová; Dace Zavadska; Guntis Karelis; Aukse Mickiene; Joanna Zajkowska; Petra Bogovič; Franc Strle; Werner Zenz

doi:10.3390/microorganisms9071420

Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017

Benno Kohlmaier, Nina A. Schweintzger, Manfred G. Sagmeister, Vendula Švendová, Daniela S. Kohlfürst, Astrid Sonnleitner, Manuel Leitner, Andrea Berghold, Erich Schmiedberger, Franz Fazekas, Alexander Pichler, Jana Rejc-Marko, Daniel Růžek, Lucie Dufková, Darina Čejková, Petr Husa, Martina Pýchová, Lenka Krbková, Václav Chmelík, Věra ŠtruncováDace Zavadska, Guntis Karelis, Aukse Mickiene, Joanna Zajkowska, Petra Bogovič, Franc Strle, Werner Zenz (Corresponding Author)

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Abstract

Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.

Original language	English
Article number	1420
Journal	Microorganisms
Volume	9
Issue number	7
DOIs	https://doi.org/10.3390/microorganisms9071420
Publication status	Published - Jul 2021

Keywords*

Central paresis
Meningomyelitis
Peripheral paresis
Tick-borne encephalitis
Vaccine-preventable disease

Field of Science*

3.2 Clinical medicine
3.3 Health sciences

Publication Type*

1.1. Scientific article indexed in Web of Science and/or Scopus database

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3390/microorganisms9071420Licence: CC BY

Clinical Characteristics of PatientsFinal published version, 509 KBLicence: CC BY

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Kohlmaier, B., Schweintzger, N. A., Sagmeister, M. G., Švendová, V., Kohlfürst, D. S., Sonnleitner, A., Leitner, M., Berghold, A., Schmiedberger, E., Fazekas, F., Pichler, A., Rejc-Marko, J., Růžek, D., Dufková, L., Čejková, D., Husa, P., Pýchová, M., Krbková, L., Chmelík, V., ... Zenz, W. (2021). Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017. Microorganisms, 9(7), Article 1420. https://doi.org/10.3390/microorganisms9071420

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title = "Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017",

abstract = "Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.",

keywords = "Central paresis, Meningomyelitis, Peripheral paresis, Tick-borne encephalitis, Vaccine-preventable disease",

author = "Benno Kohlmaier and Schweintzger, {Nina A.} and Sagmeister, {Manfred G.} and Vendula {\v S}vendov{\'a} and Kohlf{\"u}rst, {Daniela S.} and Astrid Sonnleitner and Manuel Leitner and Andrea Berghold and Erich Schmiedberger and Franz Fazekas and Alexander Pichler and Jana Rejc-Marko and Daniel Rů{\v z}ek and Lucie Dufkov{\'a} and Darina {\v C}ejkov{\'a} and Petr Husa and Martina P{\'y}chov{\'a} and Lenka Krbkov{\'a} and V{\'a}clav Chmel{\'i}k and V{\v e}ra {\v S}truncov{\'a} and Dace Zavadska and Guntis Karelis and Aukse Mickiene and Joanna Zajkowska and Petra Bogovi{\v c} and Franc Strle and Werner Zenz",

note = "Funding Information: Conflicts of Interest: W.Z. received financial support from GSK, Pfizer, Merck, and Sanofi for organizing the “Graz Vaccination Day”. Funding Information: Funding: This study was financially supported by Land Steiermark (Office of the Regional Government of Styria, Department of Health Care and Science, Unit of Science and Research, Austria). D.R., L.K. and M.P. were supported by the Czech Ministry of Health (grant No. NV19-05-00457). P.B. and F.S. were supported by the Slovenian Research Agency (grant. No P3-0296). Publisher Copyright: {\textcopyright} 2021 by the authors. Licensee MDPI, Basel, Switzerland.",

year = "2021",

month = jul,

doi = "10.3390/microorganisms9071420",

language = "English",

volume = "9",

journal = "Microorganisms",

publisher = "MDPI AG",

number = "7",

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Kohlmaier, B, Schweintzger, NA, Sagmeister, MG, Švendová, V, Kohlfürst, DS, Sonnleitner, A, Leitner, M, Berghold, A, Schmiedberger, E, Fazekas, F, Pichler, A, Rejc-Marko, J, Růžek, D, Dufková, L, Čejková, D, Husa, P, Pýchová, M, Krbková, L, Chmelík, V, Štruncová, V, Zavadska, D , Karelis, G, Mickiene, A, Zajkowska, J, Bogovič, P, Strle, F & Zenz, W 2021, 'Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017', Microorganisms, vol. 9, no. 7, 1420. https://doi.org/10.3390/microorganisms9071420

TY - JOUR

T1 - Clinical characteristics of patients with tick-borne encephalitis (Tbe)

T2 - A European multicentre study from 2010 to 2017

AU - Kohlmaier, Benno

AU - Schweintzger, Nina A.

AU - Sagmeister, Manfred G.

AU - Švendová, Vendula

AU - Kohlfürst, Daniela S.

AU - Sonnleitner, Astrid

AU - Leitner, Manuel

AU - Berghold, Andrea

AU - Schmiedberger, Erich

AU - Fazekas, Franz

AU - Pichler, Alexander

AU - Rejc-Marko, Jana

AU - Růžek, Daniel

AU - Dufková, Lucie

AU - Čejková, Darina

AU - Husa, Petr

AU - Pýchová, Martina

AU - Krbková, Lenka

AU - Chmelík, Václav

AU - Štruncová, Věra

AU - Zavadska, Dace

AU - Karelis, Guntis

AU - Mickiene, Aukse

AU - Zajkowska, Joanna

AU - Bogovič, Petra

AU - Strle, Franc

AU - Zenz, Werner

N1 - Funding Information: Conflicts of Interest: W.Z. received financial support from GSK, Pfizer, Merck, and Sanofi for organizing the “Graz Vaccination Day”. Funding Information: Funding: This study was financially supported by Land Steiermark (Office of the Regional Government of Styria, Department of Health Care and Science, Unit of Science and Research, Austria). D.R., L.K. and M.P. were supported by the Czech Ministry of Health (grant No. NV19-05-00457). P.B. and F.S. were supported by the Slovenian Research Agency (grant. No P3-0296). Publisher Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

PY - 2021/7

Y1 - 2021/7

N2 - Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.

AB - Tick-borne encephalitis (TBE) virus is a major cause of central nervous system infections in endemic countries. Here, we present clinical and laboratory characteristics of a large international cohort of patients with confirmed TBE using a uniform clinical protocol. Patients were recruited in eight centers from six European countries between 2010 and 2017. A detailed description of clinical signs and symptoms was recorded. The obtained information enabled a reliable classification in 553 of 555 patients: 207 (37.3%) had meningitis, 273 (49.2%) meningoencephalitis, 15 (2.7%) meningomyelitis, and 58 (10.5%) meningoencephalomyelitis; 41 (7.4%) patients had a peripheral paresis of extremities, 13 (2.3%) a central paresis of extremities, and 25 (4.5%) had single or multiple cranial nerve palsies. Five (0.9%) patients died during acute illness. Outcome at discharge was recorded in 298 patients. Of 176 (59.1%) patients with incomplete recovery, 80 (27%) displayed persisting symptoms or signs without recovery expectation. This study provides further evidence that TBE is a severe disease with a large proportion of patients with incomplete recovery. We suggest monitoring TBE in endemic European countries using a uniform protocol to record the full clinical spectrum of the disease.

KW - Central paresis

KW - Meningomyelitis

KW - Peripheral paresis

KW - Tick-borne encephalitis

KW - Vaccine-preventable disease

UR - http://www.scopus.com/inward/record.url?scp=85108897842&partnerID=8YFLogxK

U2 - 10.3390/microorganisms9071420

DO - 10.3390/microorganisms9071420

M3 - Article

AN - SCOPUS:85108897842

VL - 9

JO - Microorganisms

JF - Microorganisms

IS - 7

M1 - 1420

ER -

Clinical characteristics of patients with tick-borne encephalitis (Tbe): A European multicentre study from 2010 to 2017

Abstract

Keywords*

Field of Science*

Publication Type*

UN SDGs

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